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Member Research & Reports

Member Research & Reports

UAB Investigates Racial Disparities in Sepsis in the REGARDS Study

In a recent study, lead author Mr. Justin X. Moore, pre-doctoral fellow in the department of epidemiology and graduate research assistant in the department of emergency medicine at the University of Alabama at Birmingham, stated, “Sepsis is a major public health problem. Prior studies using hospital-based data describe higher rates of sepsis among Black than White participants. We sought to characterize racial differences in incident sepsis in a large cohort of adult community-dwelling adults.” Co-investigators are Mr. John P. Donnelly, graduate student trainee, and Dr. Monika M. Safford, professor, in the UAB’s division of preventive medicine; Dr. Russell L. Griffin, assistant professor in the department of epidemiology; Dr. George Howard, professor in the department of biostatistics; Dr. John Baddley, professor in the division of infectious diseases; and Dr. Henry E. Wang, professor in the department of emergency medicine.

[Photo: Mr. Justin X. Moore]

The researchers analyzed data pertaining to 29,690 participants from the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study. Adjusting for sociodemographics, health behaviors, chronic medical conditions, and biomarkers among participants, the team ascertained the associations between race and first-infection and first-sepsis events, as well as the connection between race and first-sepsis events limited to first-infection events. They then contrasted characteristics of participants and hospital course between black and white sepsis hospitalizations.

Study results indicated that there were 12,216 (41.1 percent) Black and 17,474 (58.9 percent) White participants among the eligible REGARDS enrollees. A total of 2,600 first-infection events were identified, and it was found that the occurrence of first-infection events was lower for Black than White participants (12.10 versus 15.76 per 1,000 person-years). Findings also showed that there were 1,526 first-sepsis events, with the first-sepsis events lower for Black than White participants (6.93 versus 9.10 per 1,000 person-years). When limited to first-infection events, the odds of sepsis were similar between Black and White participants. Black participants were more likely to be diagnosed with severe sepsis (76.9 percent versus 71.5 percent) when limited to first-sepsis events.

Mr. Moore concludes, “In the REGARDS cohort, Black participants were less likely than White participants to experience infection and sepsis events. Further efforts should focus on elucidating the underlying reasons for these observations, which are in contrast to existing literature.”

“Black-White Racial Disparities in Sepsis: A Prospective Analysis of the REasons for Geographic And Racial Differences in Stroke (REGARDS) Cohort” was published in July in the journal Critical Care.

Journal article: